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The introduction of anti-SARS-CoV-2 vaccines in late 2020 substantially changed the pandemic picture, inducing effective protection in the population. However, individual variability was observed with different levels of cellular response and neutralizing antibodies. We report data on the impact of age, gender, and 16 single nucleotide polymorphisms (SNPs) of cytokine genes on the anti-SARS-CoV-2 IgG titers measured 31 and 105 days after administration of the second dose of BNT162b2 vaccine to 122 healthy subjects from the health care staff of the Palermo University Hospital, Italy. The higher titers at 31 days were measured in the younger subjects and in subjects bearing T-positive genotypes of IL-1R1 rs2234650 or the GG homozygous genotype of IL-6 rs1800795 SNP. T-positive genotypes are also significantly more common in subjects with higher titers at day 105. In addition, in this group of subjects, the frequency of the CT genotype of IL-4 rs2243250 is higher among those vaccinated with higher titers. Moreover, these SNPs and TNFA rs1800629 are differently distributed in a group of subjects that were found infected by SARS-CoV-2 at day 105 of evaluation. Finally, subjects that were found to be infected by SARS-CoV-2 at day 105 were significantly older than the uninfected subjects. Taken together, these data seem to suggest that age and polymorphisms of key cytokines, which regulate inflammation and humoral immune response, might influence the magnitude of the antibody response to vaccination with BNT162B2, prompting speculation about the possible benefit of a genetic background-based assessment of a personalized approach to the anti-COVID vaccination schedule. [ABSTRACT FROM AUTHOR]

During the summer of 2016, severe dieback was observed on young potted Prunus lusitanica (Portugal laurel) plants in a nursery in the Pistoia province (Tuscany, Italy). Cylindrocarpon-like isolates were consistently recovered from diseased plant tissues. The combination of morphological and molecular traits, including sequence data of histone 3 and β-tubulin genes (HIS3, TUB2) and internal transcribed spacers (ITS), allowed the identification of Dactylonectria macrodidyma (Halleen, Schroers & Crous) L. Lombard & Crous (asexual form Cylindrocarpon macrodidymum) as the causal agent of the disease. Pathogenicity tests reproduced disease symptoms observed in the nursery after six months fulfilling Koch's postulates. D. macrodidyma is a soilborne plant pathogen and is to be considered of great economic importance on P. lusitanica, especially under favorable conditions such as stress and/or reduction of plant vitality. The increasingly frequent reports of the disease caused by the pathogen in various nurseries suggest that pot cultivation, together with prolonged drought periods, may play a role in favoring infections. To the best of our knowledge, this is the first report worldwide of the occurrence of dieback on Prunus lusitanica caused by D. macrodidyma. [ABSTRACT FROM AUTHOR]

The use of molecular tools to identify insect pests is a critical issue, especially when rapid and reliable tests are required. We proposed a protocol based on qPCR with SYBR Green technology to identify Philaenus italosignus (Hemiptera, Aphrophoridae). The species is one of the three spittlebugs able to transmit Xylella fastidiosa subsp. pauca ST53 in Italy, together with Philaenus spumarius and Neophilaenus campestris. Although less common than the other two species, its identification is key to verifying which role it can play when locally abundant. The proposed assay shows analytical specificity being inclusive with different populations of the target species and exclusive with non-target taxa, either taxonomically related or not. Moreover, it shows analytical sensibility, repeatability, and reproducibility, resulting in an excellent candidate for an official diagnostic method. The molecular test can discriminate P. italosignus from all non-target species, including the congeneric P. spumarius. [ABSTRACT FROM AUTHOR]

Complex freshwater–saltwater exchanges characterize most Holocene groundwater aquifers in low-lying coastal plains around the world, particularly in mechanically drained territories. This is due to the combination of several factors that control groundwater dynamics, including the high variability of the Holocene coastal deposits that host the shallow aquifers and the water management practices. The relationships between the stratal architecture of sedimentary deposits and the vertical changes in the salinity of the phreatic aquifer are poorly studied although they represent an issue of primary importance for a sustainable use of water resources and for agriculture. This research work is focused on the influence of sedimentary constraints, i.e., stratigraphic discontinuities and related changes in permeability in shaping salinity stratification into the unconfined aquifer at the southern margin of the Venice lagoon (Italy). Nine sites have been investigated by collecting sediment cores for facies analysis and monitoring water electrical conductivity in piezometric wells. The results show that buried channelized sandy deposits can enhance salinity mitigation of the phreatic aquifer in conjunction with precipitations and sufficient freshwater supply from nearby rivers and irrigation channels. Our analyses also reveal that the differences in stratigraphic architecture of the upper 10 m of the subsoil determine different fresh–saltwater dynamics of the phreatic aquifer. In particular, three possible behaviors can occur: (i) where the subsurface is characterized by the presence of a thick, up to 5 m, paleochannel, a freshwater lens is always present in the most surficial part of the phreatic aquifer; (ii) where the subsurface is composed by fine-grained sediments of marsh and lagoon paleo-environment, the phreatic aquifer tends to be salt-contaminated over its entire thickness; (iii) where the subsurface contains thin, up to 2–3 m, paleochannel deposits, the fresh–saltwater dynamics of the most surficial part of the phreatic aquifer varies more during the year, as a result of seasonal precipitation trend. The provided characterization of saltwater dynamics represents the basis for planning mitigation measures to improve the farmland productivity of the Venetian coastal plains. [ABSTRACT FROM AUTHOR]

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The importance of lung recruitment before surfactant administration has been shown in animal studies. Well designed trials in preterm infants are absent. We aimed to examine whether the application of a recruitment manoeuvre just before surfactant administration, followed by rapid extubation (intubate-recruit-surfactant-extubate [IN-REC-SUR-E]), decreased the need for mechanical ventilation during the first 72 h of life compared with no recruitment manoeuvre (ie, intubate-surfactant-extubate [IN-SUR-E]). We did a randomised, unblinded, controlled trial in 35 tertiary neonatal intensive care units in Italy. Spontaneously breathing extremely preterm neonates (24 + 0 to 27 + 6 weeks' gestation) reaching failure criteria for continuous positive airway pressure within the first 24 h of life were randomly assigned (1:1) with a minimisation algorithm to IN-REC-SUR-E or IN-SUR-E using an interactive web-based electronic system, stratified by clinical site and gestational age. The primary outcome was the need for mechanical ventilation in the first 72 h of life. Analyses were done in intention-to-treat and per-protocol populations, with a log-binomial regression model correcting for stratification factors to estimate adjusted relative risk (RR). This study is registered with ClinicalTrials.gov , NCT02482766. Of 556 infants assessed for eligibility, 218 infants were recruited from Nov 12, 2015, to Sept 23, 2018, and included in the intention-to-treat analysis. The requirement for mechanical ventilation during the first 72 h of life was reduced in the IN-REC-SUR-E group (43 [40%] of 107) compared with the IN-SUR-E group (60 [54%] of 111; adjusted RR 0·75, 95% CI 0·57–0·98; p=0·037), with a number needed to treat of 7·2 (95% CI 3·7–135·0). The addition of the recruitment manoeuvre did not adversely affect the safety outcomes of in-hospital mortality (19 [19%] of 101 in the IN-REC-SUR-E group vs 37 [33%] of 111 in the IN-SUR-E group), pneumothorax (four [4%] of 101 vs seven [6%] of 111), or grade 3 or worse intraventricular haemorrhage (12 [12%] of 101 vs 17 [15%] of 111). A lung recruitment manoeuvre just before surfactant administration improved the efficacy of surfactant treatment in extremely preterm neonates compared with the standard IN-SUR-E technique, without increasing the risk of adverse neonatal outcomes. The reduced need for mechanical ventilation during the first 72 h of life might facilitate implementation of a non-invasive respiratory support strategy. None. [ABSTRACT FROM AUTHOR]

The cultivation of walnuts (Juglans sp.) in Europe retains high economic, social, and environmental value. The recent reporting of the Thousand Cankers Disease (TCD) fungus, Geosmithia morbida, and of its vector, Pityophthorus juglandis, in walnut trees in Italy is alarming the whole of Europe. Although Italy is at present the only foothold of the disease outside North America, given the difficulties inherent in traditional identification of both members of this beetle/fungus complex, a rapid and effective protocol for the early detection and identification of TCD organisms is an absolute priority for Europe. Here we report the development of an effective and sensitive molecular tool based on simplex/duplex qPCR assays for the rapid, accurate and highly specific detection of both the bionectriaceous fungal pathogen and its bark-beetle vector. Our assay performed excellently, detecting minute amounts of target DNA without any non-specific amplification. Detection limits from various and heterogeneous matrices were lower than other reported assays. Our molecular protocol could assist in TCD organism interception at entry points, territory monitoring for the early identification and eradication of outbreaks, delineation of quarantine areas, and tracing back TCD entry and dispersal pathways. [ABSTRACT FROM AUTHOR]

The worldwide spread of coronavirus disease 2019 (COVID-19), caused by the new severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), was declared a pandemic by the World Health Organization (WHO) in March 2020. According to clinical studies carried out in China and Italy, most patients experience mild or moderate symptoms; about a fifth of subjects develop a severe and critical disease, and may suffer from interstitial pneumonia, possibly associated with acute respiratory distress syndrome (ARDS) and death. In patients who develop respiratory failure, timely conventional oxygen therapy through nasal catheter plays a crucial role, but it can be used only in mild forms. Continuous positive airway pressure (CPAP) support or non-invasive mechanical ventilation (NIV) are uncomfortable, and require significant man–machine cooperation. Herein we describe our experience of five patients with COVID-19, who were treated with high-flow nasal cannula (HFNC) after failure of CPAP or NIV, and discuss the role of HFNC in COVID-19 patients. Our findings suggest that HFNC can be used successfully in selected patients with COVID-19-related ARDS. The reviews of this paper are available via the supplemental material section. [ABSTRACT FROM AUTHOR]

Aim: Purpura fulminans is an uncommon, rapid progression, life-threatening syndrome is accompanied by intravascular thrombosis and necrosis of the skin and subcutaneous tissues affected multiple limbs are exposed to a high risk of limb amputation. Also has multi-organ dysfunction and may lead to death. Surgical management is important and race against time. Method: We report a case of 79-year-old, previously healthy female patient, who presented petechiae over buttock, bilateral upper and lower extremities after taken traditional medicine, then developed diffuse necrotic ecchymosis with thrombocytopenia and increased plasma fibrin-degradation products which diagnosis of purpura fulminans. Survivor is not only treated with fresh frozen plasma and aggressive management of the septic state, but also 3 times surgical wound management which including debridement, negative pressure wound therapy with irrigation and split thickness skin graft. During second operation, we found necrotic fat tissue hidden under the healthy epiderma that may be due to supported by dermal plexus circulation. Need to debride all necrotic fat tissue meticulously to avoid infection spreads. Results / Discussion: The patient is survival and discharge with right upper limb amputation. Conclusion: Purpura fulminans is an acute thrombotic disorder which rapidly leads to skin necrosis and disseminated intravascular coagulation. This report is emphasizing the importance of early aggressive surgical procedure with excisional debridement, negative pressure wound therapy with irrigation, skin grafts, early amputation of ischemic limbs and infection control can also reduce the mortality of purpura fulminans cases. [ABSTRACT FROM AUTHOR]

The original morphology and hydrogeology of many low-lying coastlands worldwide have been significantly modified over the last century through river diversion, embankment built-up, and large-scale land reclamation projects. This led to a progressive shifting of the groundwater–surficial water exchanges from naturally to anthropogenically driven. In this human-influenced hydrologic landscape, the saltwater contamination usually jeopardizes the soil productivity. In the coastland south of Venice (Italy), several well log measurements, chemical and isotope analyses have been performed over the last decade to characterize the occurrence of the salt contamination. The processing of this huge dataset highlights a permanent variously-shaped saline contamination up to 20 km inland, with different conditions in relation with the various geomorphological features of the area. The results point out the important role of the land reclamation in shaping the present-day salt contamination and reveal the contribution of precipitation, river discharge, lagoon and sea water to the shallow groundwater in the various coastal sectors. Moreover, an original vulnerability map to salt contamination in relation to the farmland productivity has been developed taking into account the electrical conductivity of the upper aquifer in the worst condition, the ground elevation, and the distance from salt and fresh surface water sources. Finally, the study allows highlighting the limit of traditional investigations in monitoring saltwater contamination at the regional scale in managed Holocene coastal environments. Possible improvements are outlined. [ABSTRACT FROM AUTHOR]

Background: Dietary intake, physical activity and other lifestyle factors, behaviors known to change in college students, may affect long-term health outcomes. The mobile Ecological Momentary Assessment (mEMA) methods represent an innovative, detailed and valid approach to capture the complexity of food intake and behaviors and to overcome limitations of traditional dietary assessment methods. The main aim of the HEALTHY-UNICT study is to characterize heating habits, including Mediterranean Diet adherence, and others lifestyle factors, and their relationship with anthropometrics and emotions in a sample of college students of the University of Catania, using real-time mEMA methods and an innovative custom mEMA application. Methods: Data will be collected using a mEMA tool administered via a web-based application. mEMA data collection will be carried out in two waves during the second semester of the academic year. During each wave, participants will receive prompts via the text messages to complete the surveys during four selected days, eight times per day. Results: This abstract describes the protocol of the study. The HEALTHY-UNICT study aims to follow university students from a large university. A total of 100 students will be enrolled in the pilot phase. Expected results are the characterization of dietary behaviors, including Mediterranean diet adherence, food choices and others lifestyle factors, including smoking habits and physical activity and their relationship with anthropometrics and emotions in the sample of college students of the University of Catania. Conclusions: The project idea should be relevant since results of the study could be useful to identify targets for the improvement of health and the promotion of healthy lifestyles in young adults. The HEALTHY-UNICT project will contribute to Sustainable Development Goals (SDGs) in the area of food and nutrition, to improve nutrition and lifestyle, through actions that combine tradition and innovation. [ABSTRACT FROM AUTHOR]

The seaport of Gioia Tauro is the largest transshipment terminal of the Mediterranean coast. A crucial management task for the companies operating in the seaport is team-building: the problem of properly allocating the available personnel for serving the incoming ships. Teams have to be carefully arranged in order to meet several constraints, such as allocation of employees with appropriate skills, fair distribution of the working load, and turnover of the heavy/dangerous roles. This makes team-building a hard and expensive task requiring several hours of manual preparation per day.In this paper we present a system based on Answer Set Programming for the automatic generation of the teams of employees in the seaport of Gioia Tauro. The system is currently exploited in the Gioia Tauro seaport by ICO BLG, a company specialized in automobile logistics. [ABSTRACT FROM AUTHOR]

Molecular analyses of a large population of isolates, previously identified as group B or genetic group A4 of the Colletotrichum acutatum species complex, mainly of Italian origin from olive, but also from other hosts collected since 1992, confirmed a well-resolved phylogenetic lineage with distinctive phenotypic characters which can be recognized as a separate species. Based on RAPD genomic fingerprinting, ITS and β-tubulin DNA sequences, this species was clearly distinct from C. acutatum sensu stricto, C. fioriniae and C. simmondsii as well as from the genetic groups A1, A6, A7 and A8, all previously referred to as C. acutatum sensu lato. Group A4 is widespread in Europe, being responsible for olive anthracnose epidemics in some Mediterranean countries, including Greece, Italy, Montenegro, Portugal and Spain; moreover, it causes anthracnose diseases on a wide range of other hosts including about 20 different genera of woody and herbaceous plants, ornamentals and fruit trees. This new anamorphic taxon is described as Colletotrichum clavatum sp. nov. [ABSTRACT FROM AUTHOR]

This essay, which constitutes the introduction to the Italian translation of Usener's Die Entwickelung der Philologie mit der Berliner Universitat, examines the situation of the classical philology in Germany (in particular, within the University of Berlin) during the 19th century, and stresses Usener's important contribution to its development and innovation. [ABSTRACT FROM AUTHOR]

In this article we discuss relevant data on aging, longevity, and gender with particular focus on inflammation gene polymorphisms which could affect an individual's chance to reach the extreme limit of human life. The present review is not an extensive revision of the literature, but rather an expert opinion based on selected data from the authors' laboratories. In 2000–2005 in the more developed regions, the life expectancy at birth is 71.9 years for men (78.3 in Japan) and 79.3 years for women (86.3 in Japan). Indeed, gender accounts for important differences in the prevalence of a variety of age-related diseases. Considering people of far-advanced age, demographic data document a clear-cut prevalence of females compared to males, suggesting that sex-specific mortality rates follow different trajectories during aging. In Italy this female/male ratio is relatively lower (about 5/1; F/M ratios are usually 5–6:1 in other developed countries), but significant differences have been observed between Italian regions in the distribution of centenarians by gender—from two women per man in the South to more than eight in certain regions in the North. Thus, a complex interaction of environmental, historical, and genetic factors, differently characterizing the various parts of Italy, likely plays an important role in determining the gender-specific probability of achieving longevity. This can be due to gender-specific cultural and anthropological characteristics of Italian society in the last 100 years. Age-related immunoinflammatory factors increase during proinflammatory status, and the frequency of pro/anti-inflammatory gene variants also show gender differences. There is some suggestion that people genetically predisposed to weak inflammatory activity may be at reduced chance of developing coronary heart disease (CHD) and, therefore, may achieve longer lifespan if they avoid serious life-threatening infectious disease thoroughout life. Thus, the pathogen burden, by interacting with host genotype, could determine the type and intensity of the immune-inflammatory response responsible for both proinflammatory status and CHD. These findings point to a strong relationship between the genetics of inflammation, successful aging, and the control of cardiovascular disease, but seem to suggest that the evidence for men is much stronger. The importance of these studies lies in the fact that half of the population (males) lives approximately 10% shorter lives than the other half (females). Understanding the different strategies that men and women seem to follow to achieve longevity may help us to comprehend better the basic phenomenon of aging and allow us to search for safe ways to increase male lifespan. [ABSTRACT FROM AUTHOR]

Immune response in elderly is characterised by a progressive loss of the ability to cope environmental stressors with a characteristic remodelling of cytokine network. One of the data constantly reported in literature is the decrease of IL-2 production. An IL-2 central role in the reconstitution of T cell function in vitro is largely documented. Studies on a T→G polymorphism at −330 nt of IL-2 gene promoter region have demonstrated that T lymphocytes from 330GG homozygous subjects are able to produce in vitro higher amount of IL-2, than −330TG heterozygous or −330TT homozygous subjects. As a genetic background conditioning the maintaining of an efficient immune response would exert positive effects on healthy ageing, we have typed for 330T/G IL-2 single nucleotide polymorphism (SNP), 168 centenarians and 214 control subjects matched for age and ancestry from Centre and South Italy to check the 330GG genotype association to longevity. The statistical analysis doesn’t show a significant difference of genotypic and allelic frequencies at −330 IL-2 T/G SNP among centenarians and controls. Comparing the two cohorts of subjects by extended Mantel Haenszel procedure a marginally significant trend for an increased -330TT genotype frequency was observed. Our data seem to be paradoxical considering the role attributed to a well-conserved T cell function in the successful ageing. On the other hand, in a recent study on a sample of Irish octogenarians a similar distribution of −330T/G genotype even was observed. These data suggest that a genetic background favouring an increased IL-2 production might be detrimental for longevity. On the other hand, an increase of IL-2 and other pro-inflammatory cytokine production characterise the Alzheimer’s disease serum profile. All in all our data seem to suggest that reduction of −330G allele frequency might be protective for healthy ageing limiting cell mediated inflammation implied in age associated diseases. [ABSTRACT FROM AUTHOR]

Summary In the light of the key role played by interferon (IFN)-γ in the control of tuberculosis, in the present paper we have evaluated the distribution of the functional +874T → A IFN-γ single nucleotide polymorphism (SNP) in Sicilian patients affected by tuberculosis. Our aim was to determine whether there is an association between the TT genotype, which has been suggested to be linked to an increased production of IFN-γ, and resistance to chronic tuberculosis. DNA samples were obtained from 45 patients and 97 healthy controls. Polymorphism at +874 was identified using amplification refractory mutational system methodology. The +874T SNP was less frequent in patients than in controls (0.42 vs. 0.50) but the difference was not significant. The +874TT genotype, which has been suggested to be associated with high IFN-γ production, was significantly decreased in the patients. Thus, resistance to chronic lung tuberculosis might be associated with a genetically determined high IFN-γ production capacity. In conclusion, the present data add another piece of evidence to the complex puzzle of genetic and environmental factors involved in control of infectious diseases. Studies on cytokine gene polymorphisms may elucidate the complex network of trans -interactive genes influencing the type and strength of responses to environmental stressors and may help to identify the genetic factors that affect survival in humans. [ABSTRACT FROM AUTHOR]

Saltwater intrusion is a growing threat for coastal aquifers and agricultural practices in low-lying plains. Most of the farmlands located between the margin of the Southern Venice lagoon and the Northern Po delta, Italy, lie a few meters below mean sea level and are drained by a large network of artificial channels and hydraulic infrastructures to avoid frequent flooding and allow agricultural practices. This work proposes an assessment of the vulnerability to saltwater intrusion, following a new concept of the hazard status, resulting in combining the depth of the freshwater/saltwater interface and the electrical resistivity of the shallow subsoil. The sensitivity of the farmland system was assessed by using ground elevation, distance from freshwater and saltwater sources, permeability, potential runoff, land subsidence, and sea-level rise indicators. Relative weights were assigned by a pairwise comparison following the Analytic Hierarchy Process approach. The computed vulnerability map highlights that about 30% of the farmlands is under strong and extreme conditions, 28% between marginal and moderate, and 40% under negligible conditions. Results from previous vulnerability assessments are discussed in order to explain their differences in terms of hazard status conceptualization and sensitivity characterization of farmland system. [ABSTRACT FROM AUTHOR]

[Display omitted] • The clinical outcome of SARS-CoV-2 infection is largely variable, and with differential age/gender related manifestations. • Some exceptional individuals recover from illness and COVID-19 complications in spite of their extreme age (nonagenarians/centenarians). • Studies on genetic and epigenetic factors on longevity trait might characterize the resistance to SARS-CoV-2 infection. • Long-lived Italian people, with multi-omics investigations could identify genetic/epigenetic basis of resistance and pharmacological targets for preventing or reducing viral infection in susceptible individuals. Like other infectious diseases, COVID-19 shows a clinical outcome enormously variable, ranging from asymptomatic to lethal. In Italy, like in other countries, old male individuals, with one or more comorbidity, are the most susceptible group, and show, consequently, the highest mortality, and morbidity, including lethal respiratory distress syndrome, as the most common complication. In addition, another extraordinary peculiarity, that is a surprising resistance to COVID-19, characterizes some Italian nonagenarians/centenarians. Despite having the typical COVID-19 signs and/or symptoms, such exceptional individuals show a surprising tendency to recover from illness and complications. On the other hand, long-lived people have an optimal performance of immune system related to an overexpression of anti-inflammatory variants in immune/inflammatory genes, as demonstrated by our and other groups. Consequently, we suggest long-lived people as an optimal model for detecting genetic profiles associated with the susceptibility and/or protection to COVID-19, to utilize as potential pharmacological targets for preventing or reducing viral infection in more vulnerable individuals. [ABSTRACT FROM AUTHOR]

Relative sea-level rise poses one of the greatest threats to transitional coastal systems around the world and it is due to changes in both sea level and terrestrial elevation. Although expected sea-level rise due to climate change is the most widespread concern, the effect of land subsidence can be much greater. Analyses of coastal vulnerability to relative sea-level rise generally neglect or over-simplify land subsidence patterns affecting large areas. This can lead to inaccurate assessments of vulnerability that do not take account of the spatial variability of ground movements. The Po delta (Italy) is a highly distinctive example of a transitional coastal environment, which hosts an extensive range of habitats and biodiversity together with archaeological and historical sites. Relative sea-level rise significantly threatens the delta, mostly due to uneven subsidence rates ranging from a few mm/yr to more than 20 mm/yr. This study is aimed at exploring the vulnerability of the Po river delta to relative sea-level rise, considering the heterogeneity of present land subsidence, various sea-level rise scenarios and the hydro-morphological setting, by means of an index-based model. The analysis shows almost 50% of the Po delta (~500 km2) currently at critical-extreme vulnerability to relative sea-level rise, exceeding 80% (~800 km2) by 2050. The model indicates uneven distribution of vulnerability over agricultural, submerged and intertidal, urbanized and forested areas due to land subsidence variability along with the complex hydro-morphological setting of the Po delta area. Considering an average subsidence value instead of the actual uneven pattern, vulnerability is over- and under-estimated in the inland and lagoon sectors respectively. Image 1 • A reliable assessment of vulnerability to RSLR at the Po delta scale is developed. • The intrinsic role of subsidence heterogeneity and other indices is investigated. • Over 50% of the Po delta is characterised by critical-extreme vulnerability, exceeding 80% by 2050. [ABSTRACT FROM AUTHOR]

The use of satellite SAR interferometric methods has significantly improved the monitoring of ground movements over the last decades, thus opening new possibilities for a more accurate interpretation of land subsidence and its driving mechanisms. TerraSAR-X has been extensively used to study land subsidence in the Venice Lagoon, Italy, with the aim of quantifying the natural and anthropogenic causes. In this paper, we review and update the main results achieved by three research projects supported by DLR AOs (German Aerospace Center Announcement of Opportunity) and conducted to test the capability of TerraSAR-X PSI (Persistent Scatterer Interferometry) to detect ground movements in the complex physiographic setting of the Venice transitional coastal environment. The investigations have been focused on the historical center of Venice, the lagoon inlets where the MoSE is under construction, salt marshes, and newly built-up areas in the littoral. PSI on stacks of stripmap TerraSAR-X images covering short- to long-time periods (i.e., the years 2008–2009, 2008–2011 and 2008–2013) has proven particularly effective to measure land subsidence in the Venice coastland. The very high spatial resolution (3 m) and the short repeat time interval (11 days) of the TerraSAR-X acquisitions make it possible to investigate ground movements with a detail unavailable in the past. The interferometric products, properly calibrated, allowed for a millimetric vertical accuracy of the land movements at both the regional and local scales, even for short-term analyses, i.e., spanning one year only. The new picture of the land movement resulted from processing TerraSAR-X images has significantly contributed to update the knowledge on the subsidence process at the Venice coast. [ABSTRACT FROM AUTHOR]

Importance: A multicenter randomized clinical trial (RCT) showed a lung recruitment maneuver using high-frequency oscillatory ventilation just before surfactant administration (ie, intubate-recruit-surfactant-extubate [IN-REC-SUR-E]) improved the efficacy of treatment compared with the standard intubate-surfactant-extubate (IN-SUR-E) technique without increasing the risk of adverse neonatal outcomes., Objective: To examine follow-up outcomes at corrected postnatal age (cPNA) 2 years of preterm infants previously enrolled in an RCT and treated with IN-REC-SUR-E or IN-SUR-E in 35 tertiary neonatal intensive care units., Design, Setting, and Participants: This was a follow-up study of infants recruited into the primary RCT from 2015 to 2018 at 35 tertiary neonatal intensive care units (NICUs) in Italy. Follow-up examinations included neurodevelopmental, growth, and respiratory outcomes of these children at cPNA 2 years. Participants included spontaneously breathing extremely preterm neonates (24 0/7 to 27 6/7 weeks' gestation) reaching failure criteria for continuous positive airway pressure within the first 24 hours of life. Data were analyzed from April 2023 to January 2024., Intervention: Infants were randomly assigned (1:1) to IN-REC-SUR-E or IN-SUR-E and then followed up., Main Outcomes and Measures: The primary outcome was the occurrence of death after discharge or major disability at cPNA 2 years. Secondary outcomes were neurodevelopmental outcomes (major disability, cerebral palsy, cognitive impairment, visual deficit, or auditory deficit), anthropometric measurements (weight, length, and head circumference), and recurrent respiratory infections and hospitalizations because of respiratory causes at 2y cPNA., Results: A total of 137 extremely preterm infants (median [IQR] gestational age, 26.5 [25.3-27.5] weeks and 75 [54.7%] female), initially enrolled in the original RCT, were followed up at cPNA 2 years, including 64 infants in the IN-SUR-E group and 73 infants in the IN-REC-SUR-E group. There were no significant differences in the occurrence of death after discharge or major disability at cPNA 2 years (IN-SUR-E: 13 children [20.3%] vs IN-REC-SUR-E: 10 children [13.7%]; P = .36). There were no significant differences in incidence of disability, cerebral palsy, or cognitive impairment in the IN-REC-SUR-E group compared with the IN-SUR-E group. There were no significant differences in anthropometric measurements (weight, length, and head circumference) between groups. There were no significant differences in the incidence of recurrent respiratory infections or in hospitalizations because of respiratory causes between groups., Conclusions and Relevance: In this RCT of lung recruitment before surfactant vs standard care there were no significant differences between the 2 groups in death, neurodevelopmental outcomes, anthropometric measurements, or recurrent respiratory infections at the 2-year follow-up. These findings can aid clinicians in decision-making for the best strategy to administer surfactant, considering long-term outcomes.

Background: Postoperative outcomes of a third-generation porcine bioprosthesis for mitral valve replacement (MVR) have been poorly addressed. The objective of this study was to perform an independent, retrospective, multicenter study on outcomes of patients undergoing MVR with a Mosaic (Medtronic Inc, Minneapolis, MN) porcine bioprosthesis., Methods: From 1998 to 2011, 805 patients underwent MVR with a Mosaic porcine valve in 11 cardiac centers. There were 465 female patients (58%), and the overall mean age was 73.5 ± 7 years. Associated procedures included coronary artery bypass grafting (201 patients; 24.9%), aortic valve replacement (152 patients; 18.9%), tricuspid annuloplasty (187 patients; 22.3%), and other cardiac procedures (116 patients; 14.4%)., Results: Median follow-up was 44 months (interquartile range, 16 to 63), with a cumulative duration of 2.769 patient-years. Early mortality for isolated elective MVR was 3.8% (12 of 313), and overall early mortality was 7.8% (n = 63). The rate of late mortality was 3.4%/patient-year (95 late deaths). At 10 years, overall survival was 57.4% (95% confidence interval [CI], 48.8% to 67.5%), and cumulative rates of cardiac- and valve-related death were 7.4% (95% CI, 4.8% to 10.1%) and 1.1% (95% CI, 0.2% to 1.9%), respectively. The 10-year cumulative rates of thromboembolic and hemorrhagic events were 6.6% (95% CI, 1.4% to 11.8%) and 3.9% (95% CI, 0.1% to 8%), respectively, and the 10-year cumulative incidence of prosthetic valve endocarditis was 3% (95% CI, 1.2% to 4.9%). Finally, the 10-year cumulative incidences of structural valve degeneration and reoperations were 5.8% (95% CI, 0.2% to 11.5%) and 4.8% (95% CI, 0.7% to 10.3%), respectively., Conclusions: This independent, multicenter, retrospective study indicated that the Mosaic porcine bioprosthesis for MVR provides satisfactory results in terms of both early and long-term outcomes up to 14 years from its implantation., (Copyright © 2020 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.)

Objectives: Increasing experience with minimally invasive cardiac (MIC) aortic valve (AV) replacement makes AV reoperations (rAVR) an appealing alternative to conventional redo surgery. The aim of the study was to compare the perioperative outcome after isolated MIC versus full-sternotomy (FS) rAVR., Methods: We retrospectively analyzed data of 116 patients from three centers who underwent rAVR by using a FS ( n  = 70, 60.3%) or a partial upper sternotomy approach ( n  = 46, 39.7%). Both groups were compared in terms of 30-day mortality by using binary-logistic regression models. Further the EuroSCORE II was used to adjust for preoperative conditions in a multivariable model. Perioperative times and complications were compared between the two groups., Results: There was no statistically significant difference in perioperative mortality between FS ( n  = 5, 7.1%) and MIC ( n  = 1, 2.2%) rAVR in the original population (odds ratio [OR] 3.462, 95% confidence interval [CI] 0.391-30,635, p  = 0.264) and after adjusting for EuroSCORE II (OR 2.759, 95% CI 0.298-25.567, p  = 0.372). Cardiopulmonary bypass- (115.5 minutes vs. 137.5 minutes, p  = 0.070) and cross-clamp times (69.0 minutes vs. 81.0 minutes, p  = 0.028) were reduced in the MIC group. There was a lower prevalence of postoperative renal failure requiring renal replacement therapy (RRT) in the MIC group 0 and 8.6% ( p  = 0.041), respectively. No differences were detected between the groups regarding postoperative complications., Conclusion: MIC rAVR is associated with reduced cardiopulmonary and cross-clamp times as well as the need for RRT as compared with FS. MIC-rAVR seems to be a viable option in surgical candidates for AV reoperations., Competing Interests: None., (Georg Thieme Verlag KG Stuttgart · New York.)

To determine whether body mass index ≥30 kg/m 2 affects morbidity and mortality rates in patients undergoing surgery for type A acute aortic dissection, we conducted a retrospective study of 201 patients with type A dissection. Patients were divided into 2 groups according to body mass index (BMI): nonobese (BMI, <30 kg/m 2 ; 158 patients) and obese (BMI, ≥30 kg/m 2 ; 43 patients). Propensity score matching was used to reduce selection bias. The overall mortality rate was 19% (38/201 patients). The perioperative mortality rate was higher in the obese group, both in the overall cohort (33% vs 15%; P =0.01) and in the propensity-matched cohort (32% vs 12%; P =0.039). In the propensity-matched cohort, patients with obesity had higher rates of low cardiac output syndrome (26% vs 6%; P =0.045) and pulmonary complications (32% vs 9%; P =0.033) than those without obesity. The overall 5-year survival rates were 52.5% ± 7.8% in the obese group and 70.3% ± 4.4% in the nonobese group ( P =0.036). In the propensity-matched cohort, the 5-year survival rates were 54.3% ± 8.9% in the obese group and 81.6% ± 6.8% in the nonobese group ( P =0.018). Patients with obesity (BMI, ≥30 kg/m 2 ) who underwent surgery for type A acute aortic dissection had higher operative mortality rates and an increased risk of low cardiac output syndrome, pulmonary complications, and other postoperative morbidities than did patients without obesity. Additional extensive studies are needed to confirm our findings.

Objective: To compare short-term application of nasal high-frequency oscillatory ventilation (nHFOV) with nasal continuous positive airway pressure (nCPAP)., Working Hypothesis: nHFOV improves CO 2 removal with respect to nCPAP in preterm infants needing noninvasive respiratory support and persistent oxygen supply after the first 72 h of life., Study Design: Multicenter non-blinded prospective randomized crossover study., Patient Selection: Thirty premature infants from eight tertiary neonatal intensive care units, of mean ± SD 26.4 ± 1.8 weeks of gestational age and 921 ± 177 g of birth weight., Methodology: Infants were randomly allocated in a 1:1 ratio to receive a starting treatment mode of either nCPAP or nHFOV delivered by the ventilator CNO (Medin, Germany), using short binasal prongs of appropriate size. A crossover design with four 1-h treatment periods was used, such that each infant received both treatments twice. The primary outcome was the mean transcutaneous partial pressure of CO 2 (TcCO 2 ) value during the 2-h cumulative period of nHFOV compared with the 2-h cumulative period of nCPAP., Results: Significantly lower TcCO 2 values were observed during nHFOV compared with nCPAP: 47.5 ± 7.6 versus 49.9 ± 7.2 mmHg, respectively, P = 0.0007. A different TcCO 2 behavior was found according to the random sequence: in patients starting on nCPAP, TcCO 2 significantly decreased from 50.0 ± 8.0 to 46.6 ± 7.5 mmHg during nHFOV (P = 0.001). In patients starting on nHFOV, TcCO 2 slightly increased from 48.5 ± 7.8 to 49.9 ± 6.7 mmHg during nCPAP (P = 0.13)., Conclusions: nHFOV delivered through nasal prongs is more effective than nCPAP in improving the elimination of CO 2 ., (© 2018 Wiley Periodicals, Inc.)

Objectives: To evaluate the changes in end-expiratory lung volume during an oxygenation-guided stepwise recruitment procedure in elective high-frequency ventilation. We hypothesized that high continuous distending pressure impedes pulmonary blood flow as evidenced by reduced lung volume measurements using respiratory inductive plethysmography. Changes in oxygenation, ventilation, and peripheral perfusion were evaluated as secondary outcomes., Design: A prospective, single center, observational, nonrandomized study., Setting: The study was conducted in a neonatal ICU in Italy., Patients: High-frequency ventilated preterm infants with respiratory distress syndrome., Interventions: During the recruitment procedure, end-expiratory lung volume measured by respiratory inductive plethysmography, oxygen saturation, perfusion index, regional cerebral and perirenal tissue oxygenation, heart rate, transcutaneous PCO2, and tidal volume were simultaneously recorded at each airway pressure step., Measurements and Main Results: In 12 preterm newborns (gestational age, 27.4 ± 0.2 wk; birth weight, 979 ± 198 g), high-frequency ventilation was initiated at a continuous distending pressure of 10 cm H2O and incrementally increased by 1-2 cm H2O every 2-5 minutes until FIO2 was less than or equal to 0.25. End-expiratory lung volume progressively increased during the initial recruitment, but decreased at the maximum airway pressure in nine patients, indicative of a reduction in pulmonary perfusion. At the end of recruitment, tidal volume was significantly higher (p = 0.002) and oxygenation was significantly improved (p = 0.002); however, mean perfusion index, postductal saturation, and mean renal tissue oxygenation values were significantly reduced (p < 0.05) compared with baseline. Mean cerebral tissue oxygenation and mean transcutaneous PCO2 values were reduced but failed to reach significance., Conclusions: High distending lung pressures increased oxygenation but decreased peripheral perfusion with no adverse cerebral side effects. Coupled with the reduction in respiratory inductive plethysmography-derived lung volume, high continuous distending pressure had adverse cardiopulmonary effects. Incorporation of lung volume and hemodynamic and oxygenation variables may guide optimum lung volume determination during high-frequency ventilation recruitment procedure while preventing adverse effects on the pulmonary circulation.

Objectives: Triple valve surgery (TVS) is still a challenge for surgeons because of prolonged cardiopulmonary bypass (CPB) and myocardial ischaemic times. The reported operative mortality rate for TVS ranges between 2.5 and 25%; long-term survival is also diminished, with reported survival rates at 5 and 10 years of 75-82 and 61-75%, respectively. The objective of our study is to define early and late clinical outcomes, reporting the initial experience in the treatment of triple valve disease through a minimally invasive approach., Methods: A retrospective, observational, cohort study was undertaken of prospectively collected data on 106 patients who underwent TVS at our institution between October 2001 and June 2013. A total of 101 procedures were done through the standard median sternotomy; however, in 5 patients, the surgical procedure was carried out through a right minithoracotomy. Univariate analysis was performed to identify predictors of early and late survival., Results: The in-hospital mortality rate was 5.6% (6 of 107 patients). Predictors of early mortality were: previous cardiac surgery [odds ratio (OR) 4, 95% confidence interval (CI) 1.08-5.2, P = 0.04], preoperative left ventricular ejection fraction (LVEF) (OR 0.9, 95% CI 0.8-1.1, P = 0.003), prolonged CPB time (OR 1.02, 95% CI 1.01-1.04, P = 0.01) and postoperative pulmonary complications (OR 8, 95% CI 5.8-41, P = 0.0001). Five- and 10-year survival rates were 85 ± 3 and 65 ± 9%, respectively. In univariate analysis, diabetes [hazard ratio (HR) 2.5, 95% CI 1-6.2, P = 0.045], preoperative dialysis (HR 3, 95% CI 2-4.7, P = 0.001), unstable angina (HR 4.8, 95% CI 1-18, P = 0.03), preoperative LVEF (HR 0.9, 95% CI 0.8-1.1, P = 0.02), concomitant coronary artery bypass grafting (CABG) (HR 2.5, 95% CI 1.5-5.7, P = 0.006), prolonged CPB time (HR 1.02, 95% CI 1.01-1.13, P = 0.006), postoperative pacemaker (PMK) implantation (HR 6.2, 95% CI 1.3-18, P = 0.01) and postoperative pulmonary complications (HR 3.3, 95% CI 2.1-7.3, P = 0.002) were found to be significant predictors of late mortality following TVS. The freedom rates from valve-related complications and reoperation at 10 years were 95 ± 2 and 97 ± 2%, respectively. The 10-year freedom rates from thromboembolism and anticoagulation-related haemorrhage were 88 ± 5 and 88 ± 4%, respectively., Conclusions: TVS offers encouraging short-term and long-term patient survival; these good results after TVS in patients with advanced valvular heart disease justify aggressive surgical therapy in these patients. TVS with a minimally invasive approach is feasible and could be another treatment option., (© The Author 2014. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.)